HomeMy WebLinkAboutStekardis, Angelo ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS I~LkNAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.nort h fork.net
TO:
FROM:
DATED:
RE:
Southold Town Building Department
Linda J. Cooper, Southold To~vn Clerk's Office
February 25, 2005
Cesspool Construction Application
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Transmitted herewith is a copy of application No. 3440
Pemlit submitted by:
Angelo A. Stekardis (RLB Construction Inc.}
for a Cesspool/Septic Tank Construction
Please re~ Jew the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
I have reviewed the application and location map of the project cited above and make the following
recouunendations:
APPROVE ~
DISAPPROVE
Conmlents: ~.' .'~
Dated
ELIZABETH A. NEVII,I,~.
TOl~bl CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS IJ~AGEMRNT OFFICER
FREEDOM OF INFOIL~L~TION OFFICER
._Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.ne(:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 ~' or Non-Residential ~ $25 __
Applicant Name /q ~qb~o /~ ~l~Oi 5
Application No. ''~ ~/V~-~
Permit No.
Applicant Mailing Address
Septic Tank ~/ or Cesspool
Brief Description of Proposed Construction or Alteration '/-LOc) ,qT~Lht tV ~CcrT),'/y
dH I!;~3 ' '
Location of Proposed Construction/Alteration:
Owner of Property: ~6~o ~T~t~o~ ~
Owner Mailing Address: ~'~ /..~0ot~ otter ('o~a:r
Ow. Prope. y^dd ss: 3q5- /TEi ·
Oc ien¢, luy .
Tax Map No: Section b l~ .0 I3 Block b ~ ,O (5 Lot O I(... 6 [~
Cross Street ~'~Ctafr~ !.5( ~g
NOTE: LOCATION MAP MUST BE SUBMITTED WITR APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITlt HEALTIt DEPARTMENT APPROVAL
Signatfire of Applicant
Date
Recoived by: ~
/,~
EXPIRES THREE YEARS
.I
PLEASE NOTE.
0
it, the applicent's responsibility to
';~,
,.,ta.n adequate sanitary distance
all water supply and sewage
I facilities.
SURVEYED: ~o,~. ,$,Zoo~
HAP OF PROPERTY SITUATE AT: O~l[~'~
TOWN OF:
COUNTY OF: 5u~o~.~-,
MAP OF: D~.
FILED:
CERT[F[ED ONLY TO:
· WALLACE T. BRYAN
LICENSED ~ SURVEYOR
39 PA~
BAYPCk]R~, ~ 1170~